Renal failure is a major clinical complication in patients suffering from diabetes mellitus type I. Specifically, patients suffering from diabetes or being at least at risk of developing diabetes have a higher prevalence for developing renal failure than others (see, e.g., Villar 2007, Diabetes Care 30(12):3070-3076; Gilbert 2008, N Engl J Med 358:1628-1630). Renal failure may appear as chronic or acute renal failure. While the acute form of renal failure most often can be addressed only by kidney function replacement measures such as dialysis or transplantation, the chronic form is progressing in a manner which allows for other therapeutic interventions as well. At its end stage, chronic renal failure also requires kidney function replacement measures such as dialysis or kidney transplantation. It is to be understood that these measures in light of the high costs for the health care system and the severe, inconvenient and cumbersome side effects for the patient are to be avoided. Therefore, an early intervention with the progression of renal failure is highly desirable. Suitable therapeutic measures comprise the administration of blood lowering drugs, an altered life style, and nutritional diets. A remaining issue in handling chronic renal failure, however, is its early diagnosis or an individual risk assessment for a given diabetes patient.
In EP 1 615 036 A1 angiogenesis markers have been reported in diabetes patients for assessing the risk of cardiovascular events. Specifically, the placental growth factor (PLGF), the vascular endothelial growth factor (VEGF) and soluble Flt-1 (sFlt-1) are mentioned as angiogenesis markers in general. Some of the patients also exhibited diabetic nephropathy. However, no measures for risk stratification for renal failure have been reported.
Thus, the technical problem underlying the present invention could be seen as the provision of means and methods for predicting the risk for renal failure in a subject suffering from diabetes in order to, e.g., select a suitable therapy which inhibits progression of the renal failure. The technical problem is solved y the embodiments characterized in the accompanying claims and herein below.